Joanie49

Any LTC faculty that lets this fly is waiting for a lawsuit or even worse patient harm or death. This totally blows my mind to be honest.. Unless you have been to NURSING school and passed NCLEX you should not be preforming ANY RN duties even with somebody "supervising" you... What is going on wherever you are working is illegal plain and simple.

Thank goodness my hospital has verses badges to hit in case of emergency... I have used mine many times. Our doctors and security and other staff members are alerted right away with our location in the hospital if this happens. Not to say this will always be able to help a situation but it helps to get others there to back you up.... :/

I am not burnt out as a nurse I am burnt out from the patients expecting 5 start hotel service, being on the bell 24/7 and NOT EVEN BEING "that ill" to be honest. I need some excitement like I said, emergent situations, codes, trauma, SOMETHING GOOD.... My patients are all geriatric, confused, incontinent, and this and that, plus they are on the unit for months for "placement issues...." That in its self can be very daunting and annoying to deal with. Not to mention my unit is often short staffed which is another frustration.... I feel like I am working in a nursing home at times which is NOT what I signed up for NO OFFENSE. Thank you all above for giving heads up and pointers, it definitely was helpful. I will have an issue with being less task oriented which I already know because I am very task oriented on the med surg floor. I know I will have a lot to learn BUT IT IS SOOO WORTH IT. I need to learn and get more experience and continue to grow as a nurse!

So basically "I can't deal anymore" with my job on a med surg unit any longer. I have a years experience which is what is required in my area for ED/ICU application.. I obviously find it nerve racking to go into a new workplace with new coworkers I don't know but at this point I need a change, badly. I am BURNT out just after a year from the work I have been doing.... I LOVE my coworkers so much (I wish I could take them with me.) I just need excitement and new things...... What were your biggest challenges from moving from med surg to ED or ICU? What advice would you give me? What were the biggest changes your noticed moving to ED/ICU area after working med surg?

On central, PICC, and Midlines I always use a 10ml flush on the line and flush 5ml into the line, draw back and check for blood return, if there is no positive blood return I do not continue or put meds though it. Normal IV's (int's) I flush and if there is no issue (pain, obvious infiltration) I go ahead and give meds. So basically I never check for blood return on normal INT's but ALWAYS for advanced lines. Hope this helps!

It sounds like your doing everything right. Reviewing from school, looking at policies, and reviewing medications. I still look medications up and I have been on a med surg unit just like you described for a year... There is always a charge nurse for questions and other senior nurses! Good luck!

Great thank you! I will take a look in the drug reference guide and state what is in there to the MD next time if another situation comes up!

I would not have attempted or even thought about trying to insert in IV in that same arm as the I&D. If there was a I&D that means there is going to be a draining wound in close proximity to an IV site....not good, and high risk for another infection and possibly sepsis. I would suggest next time using the other arm and if you cant get access ask charge nurse to attempt (they are normally very skilled.) If still not access possibly a midline or PICC would be considered in the other arm considering the patient is most likely on abx it may just work out better in the long run.

I have been a nurse for a year so I am still pretty new... I have always and only pushed metoprolol IV while a patient is on tele. Last night a patient had IV metroprolol scheduled for only B/P control and it was un-needed, his B/P's were like 120's so I called the MD and stated that number one I did not feel comfortable giving the medication w/o tele to monitor and number two the patient did not even need the medication at this time (pt was NPO so IV med's were ordered.) The MD agreed it was unneeded at this time but said that pushing metoptolol is safe w/o tele if metoprolol is only being used for B/P control? I still don't totally trust this which is why I am wondering what other nurses think? Would you push IV metoprolol for B/P control w/o tele to monitor?

I really love it!! I have been a nurse for a year now and although it can be hard it really is great! I will list a few pro's and con's for me personally! Pros Comforting people while they are at their worst and sometimes most hopeless times in their life. Sitting and talking about elderly patients lives and how they met their spouse or about their children (my fav.) Listening and only listening to a patient. Sometimes they just need somebody there to listen and vent to. Good pay and jobs anywhere if you choose to move! Meeting other people in your field or work which is like we all know " like no other field of work out there." Making a small difference in a patients day even if it is just sitting on their bed and holding their hand talking for ten minutes. Being a nurse you understand all body systems and I honestly think its amazing to know SO much about the human body and how it works Con's FAMILY MEMBERS. I work nights so I don't have to deal with many!! :) Having to deal with SOOOO many core measures and FREAKING satisfaction surveys. I swear my unit comes out with some new outlandish policy every week in our newsletter. I CANT HANDLE IT ANY LONGER. Having so much responsibility- I know this is part of the job but holy moly. I go into every shift hoping I don't get a lawsuit filed ageist me for some outrageous reason. Being in charge of peoples lives and knowing when "something is wrong"!! MD's make their 10 minute rounds and they are outski! The rest falls on us RN's to monitor and assess and notify which can be scary at times! Thank god I have amazing mentors and charge nurses!!

During clinical you will be on your feet the entire time providing patient care. You will be expected to participate in personal care of patients so yes cleaning them up and morning care and any other care they may need. You will get no special considerations just because you want to be FNP and never want to work bedside. You will still go though all the same clinicals as other students do and expect to demonstrate respectful patient care though out the clinical experience. Normal clinical hours are 16hs per week (in area at least.) In my nursing school we all went to hospitals which did not provide much of a choice per say..... we kind of took what we got for experience and built off from that...... As another poster said it is going to be difficult to secure a FNP job without any nursing experience unless they are in desperate need......Best luck to you..........

Med- surg is great to start out and get experience in! Placeing foleys, NG's, caring for chest tubes ect is all good experience. I have worked med surg for almost a year now and still like it. You learn A LOT of assessment skills, when to call the MD, when to be worried etc. My sister has worked med-surg for 12 years and still loves it... SOMEHOW lol.. It really depends on the person if they want to move into something new after gaining experience or not. Everyone is different and some love it and some HATE it!

I personally do not participate in go fund me's for my co-workers or anybody actually for that matter. I would rather make a homemade supper for their family or offer my help around their house or whatever may be needed during their time of need...

At our hospital we have a vascular access team (VAT) who are suppose to do our dsg changes/care. Long story made short it NEVER GETS DONE by them........like ever. I kind of wonder what they do during the day sometimes.........Anyway's floor nurses always end up doing all the care for the central lines/ IJ's/ PICC's. We always use chlorhexidine to cleanse.. Hope this helps!

If you are feeling uncomfortable at this job with only a week orientation I would request further job training before I quit or did anything drastic. If they can not accommodate that simple request I honestly would start looking elsewhere due to you being a new grad with limited experience. I do not feel one week is enough training at all personally.....I have only worked in acute hospitals where I got 3 months of job orientation before so I can not compare to your current job experience but patient safety comes first and it sounds like this job is lacking in that or you at least feel it is being compromised which is just as important..... Possibly talk with other nurses how they organize their days/shifts and get in a routine. I would try and give it a little longer then three weeks, it is really not a long time to be working anywhere so maybe once you get in the groove of things it will start going smoother. Being a new grad at a new job always starts off rocky honestly.... BTW if you did decide to leave the position I would DEFIANTLY give notice no matter what...... My best wishes to you!

It sounds like a very difficult position... Personally in Maine when I graduated they needed nurses so bad our whole 36 bed med surg tele/stroke floor was comprised of ALL new grads... I am totally unsure if moving is in your thoughts? It is seems like a drastic thing to do JUST to find a job BUT from how it sounds it is pretty tough in MA right now for a new grad nurse..... I saw your mentioned working nursing homes but the pay was bad....but some pay is better then no pay? I know its difficult but you could get some experience and move on to a hospital afterwards? I hope all works out for you.. best of luck :)

I have actually has this happen malp. times in my hospital. Along with 911 calls I had a pt calling dating services and leaving voicemails for people to call her back at her room telephone number...........UM YA... Anyway, if somebody wont stop calling 911 we always take the phone out of their room and security will come up to "make sure they are okay" and get back in contact with police to assure safety... In my area at least, any person using 911 without an EMERGENCY can get in trouble/ even a summons to court.... If a patient was cursing and screaming in the hallway I would definitely be calling for some haldol and a consult to eval her mental state............

I honestly never thought I would EVER be able to become a nurse. I always loved the thought and dreamed of what it may be like being able to help people for a living, making a decent salary and always being in demand for a job. I slacked off in high school BIG time and I almost did not gradate ( to this day I am still convinced they just graduated me to get "rid of me" because I was kind of a trouble maker.) After a year of endless jobs I decide I would go to my community college which ended up having a very sought out nursing program throughout my state. I still at this time never thought I was really "smart enough" to be a nurse and just took basic classes. Finally my family pushed me to go into nursing and I jumped at the thought. I ended up doing two years of pre reqs and then completed two years in the nursing program and holy hell......it was difficult but SO worth it.. Honestly after being a nurse for six months I can still not believe it is "all over with" and I am free to just get experience now without having to worry about deadlines or submitting careplans on time -_- So to whoever is reading this, if I could get though nursing school you can too. I was a poor scholar with low self esteem and felt like I would "never go anywhere in life" and I somehow ended up here now as RN . Study as much as possible, ask questions, and understand the basics and you will be 100%. It may seem like you know 'nothing' but it somehow magically all comes together somehow I promise and you really know A LOT more then you REALLY think you know!

Thanks you, what you said means a lot. I know mistakes DO happen and we are only human. It is my first error so it kind of hit me hard. I normally do write down what I have to do in detail but it JUST so happens that same night I forgot my "normal" report/ to do list and had to use a generic one which I am sure did not help either :/

I can say UWORLD and the lippincott book ware GOLD to me. UWORLD is exactly how the real NCLEX test is set up as. The screen is the same the questions are the same, without UWORLD I would not have passed the NCLEX in my opinion. Their questions are difficult but teach you a lot, you should read all of the rationals to understand and learn from them.

SO.....I was pretty overwhelmed last week with my patient load and then got an admission on top of everything...I kind of thought everything was going "okay" just a "busy med surg night." I am a new nurse with just a little over six mouths experience. My hospital has a detailed MAR which is obvious about medications, times and orders.. It is very much my own fault I did not give a PO flagyl at midnight and saw it at 5am and freaked out that I had not given it to the patient! I notified the charge nurse and MD immediately and MD just said to reschedule it- NBD basically.. No patient harm, everything is okay... I am just wondering what others have felt with their first med error? I feel really guilty and like negligent in a way.. I was confident before with medications and looking information up as needed but now I am nervous to go back for my next shift... Any advise would be helpful...

Soooo- I am almost done my 12 week orientation on a med surg floor as a new nurse... I honestly do not know why I feel uncomfortable/guilty delegating to the CNA's but I do for some reason... I am 23 and most of the CNA's are in their 40's or 50's so I think that may be a factor in this situation..? I feel bad like pawning off some of the "dirty" work but in all honestly I do not mind helping when I can (and I do) but other times during med passes or a critical situation I just can not lend a helping hand with personal care or toileting... Does anybody have any tips for a new nurse with delegation?? I guess I just do not know how to politely ask the CNA to bring somebody to the bathroom or do mouth care or etc. without sounding like a lazy nurse I guess is point I am trying to get?.... I feel like because I am so young they don't really take me seriously? Sorry this is so long I am just so new to delegating and it is very uncomfortable to me...

Honestly you need to wait until you get official results from your BON. The nclex pop up credit card test is not 100% correct. I did not even try it when I took my nclex.. Your BON should post soon I hope... Best of luck, try not to get down on yourself before you even know any official results..

I have not worked in the ED, but I have had a preceptorship experance and I thought the most helpful things my preceptor did was ALWAYS ask me before doing a skill or giving a IV med or whatever is ask if I am comfortable with it! That opened the conversation up to if I had questions or possibly reviewing the procedure before going in the room, and clearly for safety purposes!! She trusted me and knew I would say either yes or no which also built trust between us both.. Personally I find "quizzing" and like intense questioning about meds or random other things very annoying and unhelpful.. I think it is stressful personally and as a new nurse makes me feel stupid if I don't know it right off the tip of my tounge and lets face it new nurses feel lost enough... I think just casually bringing up info about a med that you may feel is important for safety or a procedure is much more helpful and will open the conversation up to the new nurse asking questions. I think honestly just being supportive of the new nurse and understanding this is a scary time coming right out of nursing school and into the real world will be key. I had a very positive preceptorship experience and I think mainly because she was a good preceptor and because we meshed well and also did not get annoyed with my 100 questions every hour lol. It sounds as though you are putting a big effort into being supportive and the best preceptor you can possibly be by reading your post above!! Best wishes!

I just wanted to thank everybody for their generous advise on this post I made awhile back. I am officially a RN and passed the NCLEX in 75 q's on June 17th!